It is important to remember that the weight of a person includes the weight of their bones. So when your child’s bone density increases as they grow, so should their weight. Unfortunately, this increase in weight can bring up eating disorder thoughts, feelings and behaviours in your child.
Bone health is especially important for children and teenagers living with an eating disorder because damage to bone density cannot be repaired.
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How Does Diet Affect Bone Health?
The impact of eating disorders on bone density varies depending on whether your child was born male or female. For the purpose of this blog, we will be referring to a child’s sex – not gender. This the sex as defined by the reproductive organs at birth. We will be only discussing those born either female and male, as the effects on intersex individuals is a very complicated and unique topic.
Anorexia nervosa is the most common eating disorder that leads to low bone density. This is because folks living with anorexia nervosa are more likely to have long episodes of starvation. If your child has a low weight, lean body mass, low fat mass and/or amenorrhea – they are at a greater risk of having low bone density. Now, you may be wondering…what is amenorrhea? Let’s walk you through it!
Amenorrhea
Amenorrhea is the medical term used for when someone abnormally misses their period. This is often because of extreme exercise, high stress or a low food intake. Folks are diagnosed with amenorrhea if they typically have a regular period but have not had their period in three months. It can also be diagnosed if they typically have an irregular period and do not have their period for six months. High levels of stress hormones in both males and females can decrease their bone formation.
Female Bone Health
Female bone density is different from male bone density largely because of the difference in reproductive hormones between the two sexes. Both estrogen and testosterone play a role in bone formation. When a female has amenorrhea due to an eating disorder, it is likely that both of these hormones are lower than they should be. Anorexia nervosa, and amenorrhea, can lead to a decrease in bone formation and an increase in bone reabsorption. Both of these changes lead to lower bone density.
Most healthy females have achieved 92% of their total body bone content by the age of 18. By their late twenties, women have 99% of their bone mineral content. This is why early intervention in teens living with an eating disorder is so important – it helps to preserve bone density. Low bone density is not reversible, and leads to a higher risk of osteoporosis later in life.
Male Bone Health
The impact of anorexia nervosa on bone density is much less studied in males than it is in females. In general, males have 90% of their total bone mass by the age of 20. Similarly to females, males living with anorexia nervosa (or the binge/purge subtype) have an increased risk of osteoporosis, especially if they have a low weight, or have lived with their eating disorder for a long period of time. Early intervention in male teens living with an eating disorder is crucial to maintain or improve their bone density. As we said above – this is an effect of the eating disorder that is not reversible with recovery.
Early intervention is crucial to preserve bone density. Low bone density is not reversible and leads to a higher risk of osteoporosis later in life.
How Can My Child Avoid Complications from Low Bone Density?
You may be wondering what the impacts of a low bone density are in your child, since low bone density cannot be repaired, and is so important. Low bone accumulation (or a lowered bone density) as a teen puts your child at a higher risk for early onset osteoporosis and fractures. It also prevents your child from achieving their peak bone mass. Luckily, there are ways to prevent your child’s bone density from getting worse if they are living with an eating disorder.
In females, estrogen may be prescribed as a hormone replacement. There is research that shows that supplementing estrogen may help to maintain or even improve bone density, and lower the risk of osteoporosis and fractures. The tricky thing is there is very little research out there to support using estrogen in the form of oral contraceptives (birth control) for improving bone density in children and teens.
Vitamin D and calcium supplements may also be prescribed to your child or teen because they support bone health. Both Vitamin D and calcium play a big role in both bone development and maintaining healthy bones. When folks consume a diet low in calcium and vitamin D, they oftentimes have low bone density. If your child is living with an eating disorder, especially anorexia nervosa, it is likely they have a diet that is very low in calcium and vitamin D because of their overall low food intake.
Both Vitamin D and Calcium play a big role in healthy bone development and maintenance.
The refeeding process is the gold standard for helping your child to maintain or improve their bone density if they are living with an eating disorder. The refeeding process is necessary when any undernourished individual increases their caloric intake after consuming little to no food for a prolonged period of time. When your child begins increasing their food intake, by default their intake of calcium and vitamin D will also increase.
How Can I Get Help for My Child?
As we said above, the refeeding process is the gold standard for maintaining or improving your child’s bone density if they are living with an eating disorder. The refeeding process can be challenging – Change Creates Change Eating Disorder Care is here to help both you and your child through the process. Click below to book a free, 15-minute consultation call with us to learn how we can best support you and your child.
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